Giovanni Foti1, Fabio Lombardo2, Massimo Guerriero3, Tommaso Rodella4, Carmelo Cicciò1, Niccolò Faccioli5, Gerardo Serra6, Guglielmo Manenti4. 1. Department of Radiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni 10, 37024, Negrar, VR, Italy. 2. Department of Radiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni 10, 37024, Negrar, VR, Italy. fabio.lombardo@me.com. 3. Clinical Research Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy. 4. Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy "Tor Vergata", Rome, Italy. 5. Department of Radiology, Verona University Hospital, Verona, Italy. 6. Department of Anesthesia and Analgesic Therapy, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni 5, Negrar, Italy.
Abstract
PURPOSE: To evaluate the role of dual-energy computed tomography (DECT) in the management of vertebral compression fractures in clinical practice. MATERIALS AND METHODS: This retrospective IRB-approved study included 497 consecutive patients with suspected acute vertebral fractures, imaged either by DECT (group 1) or MRI (group 2) before vertebroplasty. The site, number and type of fractures at imaging findings, and clinical outcome based on any change in pain (DELTA-VAS), before (VAS-pre) and after treatment (VAS-post), were determined and compared. Two radiologists evaluated DECT and MRI images (15 and 5 years of experience, respectively), and inter-observer and intra-observer agreement were calculated using k statistics. RESULTS: Both in the control group (n = 124) and in the group of patients treated by vertebroplasty (n = 373), the clinical outcome was not influenced by the imaging approach adopted, with a DELTA-VAS of 5.45 and 6.42 in the DECT group and 5.12 and 6.65 in the MRI group (p = 0.326; p = 0.44). In the group of treated patients, sex, age, lumbar fractures, multiple fractures, previous fractures, Genant grade, involvement of anterior apex or superior endplates, and increased spinal curvatures were similar (p = ns); however, dorsal fractures were more prevalent in group 1 (p = 0.0197). Before treatment, the mean VAS-pre was 8.74 in group 1 (DECT) and 8.65 in group 2 (MRI) (p = 0.301), whereas after treatment, the mean VAS-post value was 2.32 in group 1 (p = 0.0001), and 2.00 in group 2 (p = 0.0001). The DELTA-VAS was 6.42 in the group of patients imaged using DECT and 6.65 in the group imaged using MRI (p = 0.326). Inter-observer and intra-observer agreement were 0.85 and 0.89 for DECT, and 0.88 and 0.91 for MRI, respectively. CONCLUSION: The outcome of vertebral compression fracture management was no different between the two groups of patients studied.
PURPOSE: To evaluate the role of dual-energy computed tomography (DECT) in the management of vertebral compression fractures in clinical practice. MATERIALS AND METHODS: This retrospective IRB-approved study included 497 consecutive patients with suspected acute vertebral fractures, imaged either by DECT (group 1) or MRI (group 2) before vertebroplasty. The site, number and type of fractures at imaging findings, and clinical outcome based on any change in pain (DELTA-VAS), before (VAS-pre) and after treatment (VAS-post), were determined and compared. Two radiologists evaluated DECT and MRI images (15 and 5 years of experience, respectively), and inter-observer and intra-observer agreement were calculated using k statistics. RESULTS: Both in the control group (n = 124) and in the group of patients treated by vertebroplasty (n = 373), the clinical outcome was not influenced by the imaging approach adopted, with a DELTA-VAS of 5.45 and 6.42 in the DECT group and 5.12 and 6.65 in the MRI group (p = 0.326; p = 0.44). In the group of treated patients, sex, age, lumbar fractures, multiple fractures, previous fractures, Genant grade, involvement of anterior apex or superior endplates, and increased spinal curvatures were similar (p = ns); however, dorsal fractures were more prevalent in group 1 (p = 0.0197). Before treatment, the mean VAS-pre was 8.74 in group 1 (DECT) and 8.65 in group 2 (MRI) (p = 0.301), whereas after treatment, the mean VAS-post value was 2.32 in group 1 (p = 0.0001), and 2.00 in group 2 (p = 0.0001). The DELTA-VAS was 6.42 in the group of patients imaged using DECT and 6.65 in the group imaged using MRI (p = 0.326). Inter-observer and intra-observer agreement were 0.85 and 0.89 for DECT, and 0.88 and 0.91 for MRI, respectively. CONCLUSION: The outcome of vertebral compression fracture management was no different between the two groups of patients studied.
Authors: Caroline A H Klazen; Paul N M Lohle; Jolanda de Vries; Frits H Jansen; Alexander V Tielbeek; Marion C Blonk; Alexander Venmans; Willem Jan J van Rooij; Marinus C Schoemaker; Job R Juttmann; Tjoen H Lo; Harald J J Verhaar; Yolanda van der Graaf; Kaspar J van Everdingen; Alex F Muller; Otto E H Elgersma; Dirk R Halkema; Hendrik Fransen; Xavier Janssens; Erik Buskens; Willem P Th M Mali Journal: Lancet Date: 2010-08-09 Impact factor: 79.321
Authors: Alexandra Papaioannou; Nelson B Watts; David L Kendler; Chui Kin Yuen; Jonathan D Adachi; Nicole Ferko Journal: Am J Med Date: 2002-08-15 Impact factor: 4.965